*3.3.1.1 Peripheral neuropathy screening*

Evaluation of bilateral sensorial neuropathy in clinical practice requires neurological trained specialist and electrophysiological tests, which an increased burden on the national healthcare systems. In order to better select the patients who are more probably affected by neuropathy, a simpler tool was developed in 1994, namely Michigan Neuropathy Screening Instrument (MNSI) [105, 106]. It comprises a 2-step evaluation: first, a 15-item self-administered questionnaire that is scored by summing abnormal responses, followed by lower extremity examination (deformities, non-healing ulcers), assessment of ankle reflexes and of vibratory sensation. According to Herman and col., a score of more than 4 should raise the suspicion of peripheral sensorial neuropathy [106].
